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Active Ingredient: Risperidone

Risperdal is an antipsychotic medicine that works by changing the effects of chemicals in the brain

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Risperidone (Risperdal, Risperdal, Risperidone) is an antipsychotic drug, i.e. a neuroleptic, atypical antipsychotic drug. In the practice of psychiatrists, it has been used since 1993, mainly for the treatment and prevention of schizophrenia. But sometimes prescribed for depression, when a person begins to feel a strong apathy, mood deterioration, loss of performance, loss of social contacts, and interest in life.


Its action has long been known and well studied.

  • It has an antipsychotic effect, i.e. it treats various psychoses.
  • It has a well-expressed hypnotic effect, i.e. it normalizes sleep.
  • It has a pronounced sedative, calming effect, removes anxiety, fussiness.
  • It has a muscle relaxant effect, i.e. it relaxes the muscles.
  • Expressed antiemetic effect.


The drug is used and produced in the form of tablets of 1, 2, and 4 mg. It is released strictly on the prescription of a psychiatrist because it belongs to the group of psychotropic drugs neuroleptics. Moreover, the prescription is issued on a special form and only based on the conclusion of a psychiatrist.

Usually, Risperidone is first prescribed in a dose of 0.25 or 0.5 mg 1 time a day in the morning. During the first day, the patient's reaction is monitored. If there are no undesirable manifestations, including allergies, then the dose is gradually increased and carefully observe how the patient responds to treatment. The therapeutic dosage is always very individual. But the maximum is 4 mg per day.


Patients during treatment should not be surprised by "strange" questions from the treating doctor, seemingly unrelated to depression or other conditions for which the drug was prescribed. For example, questions about deja vu or cases when you take a random passerby for someone you know, about situations of a paranoid nature, such as the thoughts "aren't their security cameras in the shower?" or "what if the person I'm talking to is reading my thoughts?" and so on...

Is it worth it to panic over such questions from the doctor and prescribe them a long-term intake of Risperdal? Not worth it. You don't have to have some kind of severe psychotic disorder. There may be no such disorder, but simply Your type of nervous activity or nervous system requires additional support.

The doctor can leave taking Risperdal "for prevention" for several years and recommend to come to the appointment once a quarter, without going into detailed explanations of what prevention is in question and why such a long-term drug intake is needed.

The clinical picture that corresponds to depression is:

  • worsening of mood;
  • reduced physical and mental activity.

But if at the same time there are signs of anxiety, some obsessions, apathy, the doctor may ask "strange" questions and prescribe long courses of drugs, including Risperdal.

If the attending doctor does not want to explain his behavior and appointment for one reason or another, it is better to accept the idea that he knows best. It is better to trust the doctor, not your judgment. Let the doctor decide for himself whether to tell you this, or not or in what wording to give you this information.

In principle, average intellectual abilities are enough to guess what disease development can be contained and prevented by taking Risperdal, i.e., what suspicions the doctor keeps silent about. Yes, it may not be depression or a neurotic disorder. However, the appointment of 2-year prevention is not a clear confirmation of the diagnosis of schizophrenia. This can be a variety of options.

The fact is that in addition to the actual psychotic disorders, in which risperidone is used to a greater extent, It, like any other neuroleptic, including the original neuroleptic Aminazine, gives "blissful insensibility". It has the property of slowing down the psyche, reducing its ability to quickly respond to external stimuli, creating a background of the least traumatic nervous system.

A long course of taking Risperidone, the doctor may prescribe, wanting to be safe, not to allow a relapse of depression, if he saw that the drug individually "went well" and gave an obvious positive effect at the previous stage of treatment. Therefore, you should not be afraid of long courses of taking Risperidone.


Since Risperidone is an antipsychotic and neuroleptic, it is primarily prescribed for such a mental disorder, which is called schizophrenia. More often – at the stage of the debut, when the first signs of schizophrenia appear or when it is suspected.

They also treat exacerbations in the" fur-like "course of schizophrenia. I.e., in the "manifest" state, when there are bright hallucinations, delusional disorders when violations of thinking and perception are obvious.

In many cases when there is a change in behavior, mood when there is excitement or changes at the level of emotional manifestations. This includes cases of severe depression. When there is a manifestation of negativity, refusal of treatment, or eating.

Also, the drug is used in the complex therapy of various organic diseases of the brain, accompanied by schizoid effects such as delusions and hallucinations. Also, this drug is prescribed when mental diseases of different etiologies are accompanied by anger, aggression, i.e. affective emotional manifestations that interfere with treatment.

In many situations when there is a decrease in energy potential, when emotional exhaustion is expressed, detachment from relatives and friends, when autism is expressed (isolation in itself).

In depression, it is prescribed only when the disease is accompanied by pronounced psychotic effects. When severe depressive symptoms are added to, for example, delusional changes, panic attacks, and anxiety.

But the main purpose of the drug is to remove obsessions in schizophrenia. There is in psychiatry the concept of the Kandinsky-clerambault syndrome when patients are sure that they are being influenced from outside as if someone controls their thoughts, actions, actions, emotions, and body. Patients at this time feel that they are being manipulated like dolls. They are at this time experiencing fear, anxiety, confusion. These are the manifestations that Risperdal removes.



An anxious person may be recognized on the street several times a week, but this is not considered a sign of any disease or mental disorder for years. As a rule, a person who does not perceive himself as ill, who has been suffering from schizophrenia or anxiety depression for years, does not apply any special psychotherapeutic methods, but simply tries to encourage himself to be more active in various ways. Periodically, the condition of these patients improves.

Many patients may not take seriously and generally take into account the alcoholism of close relatives or the diagnosis of one of the "sluggish schizophrenia". Especially if this diagnosis was made somewhere in the 80-s of the last century, allegedly only for the "slope from the army", and did not manifest itself in any way since then.


Considering the effects of psychotropic drugs in monotherapy of conditional average neurosis of an anxiety-depressive nature, the side effects may be quite different than expected. Different people will experience them in different ways.

Risperdal is a typical neuroleptic. However, it differs from most similar drugs in that it often causes severe side effects. This is the" heavy artillery " of psychiatry.

As for the effect on the cognitive and communicative sphere, the drug significantly reduces the dynamics of mental processes, including inhibited thinking, memory, attention. There is also a powerful sedative effect characteristic of all antipsychotics. It does not allow a person to engage in purposeful, organized mental activity.

In the emotional sphere, in terms of stabilizing effect, the drug leads to emotional stability. An unpleasant side effect on the emotional sphere is depressing, leading it to an apathetic state, it becomes flattened and expressionless. People under the influence become unresponsive as if they were made of wood.

This is why you should be careful with this neuroleptic for depression because it can cause secondary negative symptoms, or secondary deficiency syndrome. This condition is similar to the primary negative symptoms of schizophrenia when there is apathy, emotional emasculation, and flattening, abulia, complete lack of will. This condition can be excruciating and many times stronger than any depression.

The good news is that such effects can only occur with long – term treatment with large doses, especially when combined with other neuroleptics.


As for the effect on behavioral characteristics, here, as with almost all antipsychotics, when taking the drug, the appetite increases. I.e., there is a change in eating behavior.

As for the sexual sphere, Risperidone, like all psychotropic drugs, does not affect it in the best way. Effect on sexual behavior and General sexual functionality are worse than Quetiapine and Olanzapine.

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About motivational characteristics, the appearance of new insights, great breakthroughs during treatment does not receive. Motivational factors are changed rather in a negative direction than positive.

A person under the influence of Risperdal will not be drawn to do things that he did not do before, to organize something, to select technical means, to approach some professional issues more competently. On Risperdal, on the contrary, motivation goes away, professional activity decreases, a person ceases to take on even those tasks that are easy everyday tasks for him.


This drug is used mainly in large psychiatry for the treatment of schizophrenia, and in the "fashionable" now depressions-only in the complex therapy of severe cases, which, in addition to purely depressive manifestations, are characterized by pronounced psychotic effects, and they need to be extinguished. Ie, with just anxiety States, it is better to give preference to other, lighter, drugs.

By: Dr. Steven Dubovsky, MD


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